Active NPI
Angelita Yovanni Carrasco
- Peer Specialist
- Salem, OR
National Provider Identifier
1558219295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 26-CRM-5138
- Practice address
- 1144 Center St NE
Salem, OR 97301-2523 - Phone
- (503) 363-2021
- NPI assigned
- Mar 18, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 26-CRM-5138 | OR | Primary |
Addresses
Primary practice location
1144 Center St NE
Salem, OR 97301-2523
Mailing address
1529 Wiltsey Rd SE
Salem, OR 97306-8510
Phone (971) 301-9395
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26-CRM-5138 | OR | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeway Recovery Services | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/bridgewayrecovery/r4/
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Bridgeway Community Health
- Addiction (Substance Use Disorder) Counselor
- Salem, OR
- NPI 1083844401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1558219295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1529 WILTSEY RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973068510",
"telephone_number": "971-301-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1144 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012523",
"telephone_number": "503-363-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "ANGELITA",
"middle_name": "YOVANNI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-18",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "26-CRM-5138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.